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Medicaid Coverage Changes
Coming in 2027.
Everybody deserves
to live a healthy life,
including you.
Starting January 1, 2027, some adults ages 19–64 with Medicaid will see changes to their coverage. This is a new rule from the federal government. Not everyone will be affected. Some people will need to renew their plan every six (6) months rather than once a year. Some people will have work/school/community service requirements to fulfill. If these changes apply to you, New York State of Health (NYSOH) will contact you directly.
Premiums are $0/month for eligible individuals, with coverage widely accepted by doctors, hospitals and pharmacies. Individuals under age 65 may be eligible based on New York State household income and size guidelines.
- No Cost Preventive Care including vaccines, flu shots, checkups and screenings to keep you and your family healthy
- Adult dental and vision coverage now included
- Enroll anytime in the Essential Plan
- Prescription savings and home delivery
Medicare provides coverage if you are 65 or older or have a disability, regardless of income. Choose your Medicare plan with confidence from the company your neighbors have trusted for over 90 years.
- Turning 65? Find a Medicare plan that suits your needs
- Medicare plan options starting at $0/month
- Plans packed with extras like dental, vision, and hearing benefits
- Medicare plans accepted by a large network of doctors and specialists
- Knowledgeable local representatives to talk you through your options
If you have both Medicare and full Medicaid, we have a great plan for you, which makes better care simpler and more affordable for people in our community.
- $0 monthly premium
- Low-cost prescription coverage
- Hearing services: $0 copay for select hearing aids (annually for each ear)
- Dental: $0 copay for preventive and comprehensive care
- Vision: routine eye exams with $200 allowance for eyewear
- OTC monthly allowances and more
We're here to discuss your needs, answer questions about plans and help you and your employees embrace their health and well-being.
- Learn how synchronized care ensures lower costs, better care, and easier administration for you and your team
- Help your team make the most out of high deductible health plans
- Discover how telemedicine is saving employers and employees money and boosting productivity
At $0 a month for eligible individuals, with coverage widely accepted by doctors, hospitals and pharmacies. Individuals under age 65 may be eligible based on New York State household income and size guidelines.
- No Cost Preventive Care including vaccines, flu shots, checkups and screenings to keep you and your family healthy
- Adult dental and vision coverage now included
- Enroll anytime in the Essential Plan
- Prescription savings and home delivery
Medicare provides coverage if you are 65 or older or have a disability, regardless of income. Choose your Medicare plan with confidence from the company your neighbors have trusted for over 85 years.
- Turning 65? Find a Medicare plan that suits your needs
- Medicare plans with $0 premiums and $0 generic drugs
- Low-cost plans including vision and new dental benefits
- Medicare plans accepted by a large network of doctors and specialists
- Knowledgeable local representatives to talk you through your options
We're here to discuss your needs, answer questions about plans and help you and your employees embrace their health and well-being.
- Learn how synchronized care ensures lower costs, better care, and easier administration for you and your team
- Help your team make the most out of high deductible health plans
- Discover how telemedicine is saving employers and employees money and boosting productivity
Age 18 or younger
✓ Age 65 or older
Caring for a child under age 14
✓ Pregnant now or were pregnant in the last 12 months
Age 65 or older
✓ Enrolled in Medicaid because of a disability
Meeting SNAP work rules
✓ Living with a physical or mental health condition that makes it hard to work
Pregnant now or were pregnant in the last 12 months
✓ Enrolled in Medicare
Meeting TANF work rules
✓ American Indian or Alaska Native
Enrolled in Medicaid because of a disability
✓ Caring for a person with a disability
Making part in a drug or alcohol treatment program
✓ Caring for a child under age 14
Living with a physical or mental health condition that makes it hard to work
✓ Meeting SNAP work rules
In jail or prison, or released in the last 90 days
✓ Meeting TANF work rules
Enrolled in Medicare
✓ Making part in a drug or alcohol treatment program
In foster care
✓ In jail or prison, or released in the last 90 days
American Indian or Alaska Native
✓ In foster care
A former foster care youth who qualifies for this protection through age 26
✓ A former foster care youth who qualifies for this protection through age 26
Caring for a person with a disability
✓ A veteran with a total disability
A veteran with a total disability
✓ A veteran with a total disability
Working
New Work Rules for Some Adults
Going to school
Starting January 1, 2027, some adults with Medicaid may need to show they are:
✓ Working
Taking part in job training
✓ Going to school
✓ Taking part in job training
Volunteering in their community
✓ Volunteering in their community
If you need to meet these rules, NYSOH will tell you what to do and when to do it.
If you need to meet these rules, NYSOH will tell you what to do and when to do it.
Members must show compliance with the new requirements at renewal time. Renewals for January and February start in 2026, so these members do not need to comply with these requirements until their next renewal.
For example, a member renewing in March 2027 must show compliance for at least one month prior to their renewal.
New members must show compliance with the new requirements for the month immediately before they apply.
New members must show compliance with the new requirements for the month immediately before they apply.
For example, someone applying in February of 2027 must show compliance in January 2027.
✓ For example, someone applying in February of 2027 must show compliance in January 2027.
If you lose coverage because you did not meet the work rules, you may be able to show that you met the rules or apply again.
Your income
Some people with Medicaid will need to renew their coverage every 6 months instead of once a year.
You may need to share information about:
The people who live in your household
✓ Your income
✓ The people who live in your household
You may need to fill out forms or send documents two times each year. If you do not send in the information needed on time, you could lose your coverage.
Members with this requirement will transition to 6-month renewals after their first renewal in 2027.
For example, if your renewal happens in October of 2026, you will not change to the 6 month renewal schedule until October of 2027.
✓ For example, if your renewal happens in October of 2026, you will not change to the 6 month renewal schedule until October of 2027.
Logging in to your NY State of Health account at nystateofhealth.ny.gov
The most important thing you can do right now is make sure NYSOH has your current mailing address, email address and phone number.
Working with an enrollment assistor
You can update your information by:
Calling NY State of Health at 1-855-355-5777 (TTY: 1-800-662-1220)
✓ Logging in to your NY State of Health account at nystateofhealth.ny.gov
✓ Working with an enrollment assistor
✓ Calling NY State of Health at 1-855-355-5777 (TTY: 1-800-662-1220)
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